Revenue Cycle Collector

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee designated insurance accounts receivable, concentrating on aged, high-value, and priority revenue.

• Achieve set productivity, quality, and accuracy standards.

• Conduct collection activities to progress claims towards payment or final resolution.

• Investigate unpaid, denied, and underpaid claims to determine underlying issues.

• Address denials, rejections, underpayments, authorization concerns, eligibility problems, and other payer obstacles.

• Choose resolution methods including corrected claims, reconsiderations, appeals, payer escalations, and internal escalations.

• Adhere to payer-specific guidelines for timely filing, reconsiderations, appeals, and dispute resolution.

• Communicate with payers to secure claim status, processing information, reference numbers, and next steps.

• Maintain clear, comprehensive, and actionable documentation for accounts.

• Set follow-up dates and manage claims throughout the collection process.

• Identify recurring payer trends and systemic issues, escalating them for broader resolution.

• Collaborate with Billing, Authorization, Intake, Cash Posting, Patient Collections, and RCM leadership.

• Prioritize inventory based on financial exposure, aging, timely filing risks, and recovery potential.

• Maintain accountability for assigned inventory until payment or final resolution is reached.

• Assist in reducing aged AR, enhancing cash recovery, and resolving inventory issues.

⛳️ Requirements

• A minimum of 3 years of experience in healthcare insurance collections or AR follow-up, ideally in infusion, specialty pharmacy, physician practice, or another complex specialty setting.

• Proven track record in managing aged and high-value accounts receivable.

• In-depth understanding of commercial and government payer processes.

• Experience in resolving denials, underpayments, authorization challenges, eligibility issues, and claim-processing mistakes.

• Familiarity with corrected claims, reconsiderations, appeals, timely filing mandates, and payer escalation processes.

• Capacity to interpret EOBs, ERAs, payer communications, and claim-processing details.

• Strong discipline in account documentation and follow-up.

• Ability to independently prioritize a substantial inventory based on risk, aging, and financial implications.

• Capability to work efficiently within established productivity and quality benchmarks.

• Excellent analytical and problem-solving abilities with the skill to identify trends and recognize when broader escalation is necessary.

• Prior experience with infusion or specialty medication billing and collections is highly preferred.

🏝️ Benefits

• Medical, dental, and vision insurance through our employer plan.

• Short and long-term disability coverage.

• 401(k) plan with employer matching.

• 15 days of paid time off (PTO).

• Competitive paid parental leave.

• Flexible return-to-work policy.

• Opportunities for professional development.

• Potential for career advancement.